Restarting anticoagulation may be cost-effective in some VTE cases

(HealthDay News) — Restarting anticoagulation therapy may be cost-effective for patients with a predicted 1-year venous thromboembolism (VTE) risk of 17.5% or higher, according to a study published in the Journal of Thrombosis and Haemostasis.

Mark Monahan, from the University of Birmingham in the United Kingdom, and colleagues examined the long-term cost-effectiveness of using a decision rule for restarting anticoagulation therapy vs no extension of therapy based on a patient’s risk of further unprovoked VTE. A Markov patient-level simulation model was developed, which adopted a lifetime time horizon from the perspective of the UK National Health Service/Personal Social Services.

The researchers found that if decision makers are willing to pay up to £20,000 per quality-adjusted life-year gained, treating patients with a predicted 1-year VTE risk of 17.5% or higher may be cost-effective. The model was highly sensitive to overall parameter uncertainty, warranting caution in choosing the optimal decision rule on the grounds of cost-effectiveness. Anticoagulation therapy disutility and mortality risks were highly influential for driving the results in univariate sensitivity analyses.

“This represents the first economic model to consider the use of a decision rule for restarting therapy for unprovoked VTE patients,” the authors write. “Better data are required to predict long-term bleeding risks on therapy in this patient group.”

ClinicalAdvisor.com is for nurse practitioners and physician assistants, offering the latest information on diagnosing, treating, managing, and preventing medical conditions typically seen in the office-based primary-care setting.

Find all of the news and departments you love from the print issue archived for easy online access, along with special Web-only content.